Date of Award
Master of Arts (MA)
Youth with spina bifida (SB), a congenital birth defect affecting the central nervous system, are at risk of experiencing an array of psychosocial and functional deficits (Copp et al., 2015; Holmbeck et al., 2003). Indeed, previous research has documented difficulties across the three adaptive functioning domains outlined by the American Association on Intellectual and Developmental Disabilities (AAIDD): conceptual (e.g., communication, self-direction, functional academics), social (e.g., interpersonal skills), and practical (e.g., self-care, navigating health-care; Copp et al., 2015). Despite this evidence, whether or not children with SB typically acquire skills across development is largely unknown. Additionally, little is known about risk and protective factors that may influence long-term adaptive functioning outcomes in this population. Therefore, the current study examined (1) trajectories of adaptive functioning in youth with SB as they transitioned from childhood into adolescence, (2) neuropsychological functioning as a potential risk factor for long-term difficulties, and (3) parental scaffolding as a protective factor that may buffer the negative impact of cognitive dysfunction on adaptive functioning. Participants (n = 131, Mage T1 = 11.26) were recruited as part of a larger ongoing longitudinal study (Devine et al., 2012). the current study included parent report of six adaptive functioning skills across the three AAIDD domains: communication, self-direction, functional academics, social, self-care, and home living skills. Additionally, youth's attention and executive functioning (i.e., working memory, planning/organizational skills, cognitive flexibility, inhibition) were assessed via parent- and teacher-report, as well as performance-based assessments. Finally, parental scaffolding was assessed via observational data. Youth's communication, self-direction, functional academics, self-care, and home living skills increased over time across age, whereas youth's social skills did not. Rather than predicting growth in adaptive functioning, better attention and executive functioning predicted a higher intercept for most adaptive functioning abilities at 11.5 years old. Two significant moderation effects emerged, such that maternal scaffolding moderated the association between 1) youth's planning/organizational abilities and home living skills and 2) youth's inhibition abilities and functional academics skills. Results indicate that youth with SB acquire skills across development to better meet the demands of daily life. However, youth with poorer neurocognitive functioning may demonstrate adaptive functioning deficits in early childhood and benefit from timely intervention. Parental scaffolding may be one mechanism for intervention, yet additional research examining the impact of parenting on adaptive functioning is needed in this population.
Winning, Adrien, "Trajectories of Adaptive Functioning Among Youth with Spina Bifida: The Influence of Neurocognitive Functioning and Parental Scaffolding" (2020). Master's Theses. 4353.
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